330848 10/09/18 y CITY OF CARMEL, INDIANA VENDOR: 365288
ONE CIVIC SQUARE KURTIS BAUMGARTNER
�� CHECK AMOUNT: S*******,125.92*
'i,•
4. CARMEL, INDIANA 46032 16930 KINGSBRIDGE BLVD CHECK NUMBER: 330848
9.y���TON,�:d; WESTFIELD IN 46074 CHECK DATE: 10/09/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4343000 REIMB 75.92 TRAVEL FEES & EXPENSE
1091 4344100 REIMB 50.00 CELLULAR PHONE FEES
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
VOUCHER NO. WARRANT NO.
An invoice of bill to be properly itemized must show;kind of service,where performed,dates service rendered,by
Vendor# 365288 Allowed 20_ whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
Baumgartner, Kurtis Payee
16930 Kingsbridge Blvd
Westfield, IN 46074 In Sum of$ Purchase Order#
365288 Baumgartner, Kurtis Terms
$ 125.92 16930 Kingsbridge Blvd Date Due
Westfield, IN 46074
ON ACCOUNT OF APPROPRIATION FOR
109-Monon Center
PO#ornvolce Description
Dept# INVOICE NO. ACCT#/TITLE AMOUNT Invoice Date Number (or note attached invoice(s)or bill(s)) PO# Amount
1091 Reimb 4343000 $ 75.92 Board Members 9/28/18 Reimb Travel Expenses NRPA Conference $ 75.92
1091 Reimb 4344100 �+$ 50.00 10/1/18 Reimb Cell Phone Reimbursement Sep'18 $ 50.00
I hereby certify that the attached invoice(s),or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
$ 125.92 Total $ 125.92
October 1,2018
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
Cost distribution ledger classification if
claim paid motor vehicle highway fund Signature ,20
Accounts Payable Coordinator Clerk-Treasurer
Title
Carmel * Clay
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
9/25/2018 Circle Center Mall 1091 4343000 Travel Fees&Expenses $ 18.00 NRPA Conference
9/25/2018 Conner's Restaurant 1091 4343000 Travel Fees&Expenses $ 25.71 NRPA Conference
9/25/2018 Subway 1091 1 4343000 Travel Fees&Expenses $ 10.21 NRPA Conference
9/26/2018 Circle Center Mall 1091 4343000 Travel Fees& Expenses $ 22.00 NRPA Conference
All receipts should be attached in the same order as listed above.
No sales tax will be reimbursed. -T TOTAL: $75.92
Employee Name(print) Kurtis Baumgartner G
Address 16930 Kingsbridge Blvd. OCTCheck - 1 2018
payable to: City, St, Zip Westfiel N 46074
Y:
...... .............
Signature: Approved by:
Date: 9/28/2018 Date: f a l (I Lr7
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request
Indianapolis Marriott Downtown
circle center Mall
49 Maryland St Conner's Restaurant
Indianapolis, IN 46204 TABLE# 41/5 Indianapolis, Indiana
SERVER 1075/Bree
F/C #12 A Payment No-00029344 CHECK# 4887 1075 Bree
T/D #40 Ticket No.006168 --------------------------------
Cashier. ID #188 2018/09/25 12:19:11 4 7 /5 CHK 4887 GST 1
Entry Time 9/25/2018 (Tue) 8:18 ----- -8 1146AM
Paid Time 9/25/2018 (Tue) 17:42 Authorize ---------------------------------
Parking Time 9:24
Parking Fee Rate A $18. 429016792 1 Soda 3.00
00 MERC ID:0010600008030
REF No:' 92516.19.11. CHIP 1 Mac & Cheese 16.00
VISA CT No: ****** *****6222
Account # *****************************6222 EXP: XX/XX Subtotal . .. .. 19.00
Slip # 12142 CARD: VISA Tax .. . .. . .. . . 1.71
014217 CheckNo:4887 Total-Due -.:-20 e--71
Auth Code TableNo:41/5
CREDIT CARD AMOUNT $18.00
Cash Amount $0.00 Subtotal: USD20.71
_0, ***NOT A CREDIT CARD VOUCHER***
Total $18.00 Tip: —
Thank You and Have a Nice Day! Total: 25.71 GRATUITY
World Garage Booth 12 r, TOTAL
APPROVAL CODE, 11 -12
-
PRINT NAME -
X
SI ATURE SIGNATURE
.CUSTOMER COPY ROOM NUMBER
Subwa!6'4388'7.-() Ftiorie 317-896-8960
212: WE:,;': 161st Street
WI':3t:'f E Id., Ind'kana, .46074 ... .
Ser<<ec by: 13 9/2,q',018 7:26:25 pm
Term I'll--Tra.ns# 1;A-.203390
-- -- -. : - . _-.. Qty Size Tti::T] Price
= •1 12" St:!ak ,' Chs'e Suh 7.99
Circle Center Mall '' C10''ki.' 1 .38
46 Maryland St Sub Tc tial
Indianapolis, In 46204 9:37
General ";3aT s T,,j< (, ;19G;� 0.84
F/C #08 A Payment No.00012305 Total (Eat :In) 10.21
T/D #40 Ticket No.006702 CrEdit Card 10.21
Cashier ID #107 Cha 19E 0.00
Entry Time 9/26/2018 (Wed) 10:32 Tell LIS abE ui: !tujr iirlis it I) SiJEIWAU 46867
Paid Time 9/26/2018 (Wed) 22:55 Please, contau:t
Parking Time 12:23 Eva Lebi - iai:ol-e Manager 317-.896-8960
Parking Fee Rate A $22.00 A Ph ro ,;j.l IJ,�: 09,261
RE fererl t No: Ei;i'.(iE3;?;3`:3013911
VISA Carr) l:,Esu::r. 111�sa
Account # *****************************6222 Account Ni7: 14:k:14*6222
Slip # 04868 Acgi..ri rid: Ccinta(rl:,-E:MV
Auth Code 005522 tirrlou'r:: ;61(1,21
CREDIT CARD AMOUNT $22.00 API)licat i:)Ii U1aE1 I:1E1131T
Cash Amount $0.00 A1 11): AC1000O�1)031010
_ T VR: 131DE;100(K-1000
Total
_ =22.00 T;31 6200
Thank you and Have a Nice Day!
Da.tE.,�Tin;: 9�;'Gi;121016 7:26:19 PM
World Garage Booth 8
C.13TOMER COPY
Host C rder,:I(1': i;i�� dOt;,=;:3424fi9Ei
Hun@ry- for mora"? Let Lis Iknow how we didl
today by t,alk'ing ]ur 1 rntlnuut:e! survey at
www.subr�a�yl istl;uir.rraa„ irnd receive a
Subpri St, offer 't) lj,so wi I.'h )nn.ir next
purcha.Se.
Carmel 9 Cray
Parks&Recreation
Employee Expense Reimbursement Request
Date of Fund Account Account
Receipt Vendor listed on receipt # Line# Budget Description Amount Purpose of Expense
September Cell
10/13/2018 AT&T 1091 4344100 Cellular Phone Fees $ 50.00 Reimbursement
JAIIipts should be attached in the same order as listed above.
No sales tax will be reimbursed. TOTAL: $50.00
Employee Name(print) Kurtis Baumgartner
Check Address 16930 Kingsbridge Blvd.
payable to: City, St, Zip e%ftld. IN 46074
Signature: Approved by:
Date: 10/1/2018 Date: �-
Business Services Division,Revised 7-7-08
FILE: Shared\Forms\Business Services\Employee Exp Reimb Request